Emerging from out of the shadows? Service user and carer involvement in systematic reviews

The systematic review methodology literature refers to the importance of involving stakeholders, including service users and carers, in the research. However, compared with other aspects of the methodology, this aspect of conducting systematic reviews is under-developed and the practice of involvement appears highly variable. This article draws on the experience of working with service users and carers in one systematic review to review the barriers to participation and the components of effective involvement. It suggests that quality standards can be identified for service user and carer involvement in systematic reviews, which will benefit policy and practice development

Law Learning in Action: An Action Learning Project to Evaluate Processes and Outcomes of using Law E-learning Objects in Social Work Education

This document reports on a research project funded by the Social Care Institute for Excellence to evaluate the processes and outcomes (for social work students and educators) of using a suite of e-learning objects within law teaching on social work degree programmes. The e-learning objects in question were published by SCIE in 2007, and those involved in their development were keen to explore how they were being used, and what their impact might be. The research, which started in 2008 and reached completion in 2010, has tracked a group of educators in 6 universities as they have engaged in a process of collaborative capacity building, through participation in a learning set designed to support their own engagement with e-learning and to develop skills in evaluating their outcomes for students. A full list of the SCIE law e-learning objects and their associated learning outcomes is given at Appendix 1

Carers as partners in social work education

This report explores the extent and nature of participation by caregivers in the education of social work students in England. A national survey gave rise to a series of telephone interviews with education providers; regional workshops then brought together for discussion representives of carers' organisations, individual caregivers and educators. The study identified the ways in which caregivers are involved in educating social work students, the challenges experienced, the factors that facilitate positive involvement, and the outcomes experienced by those involved. The report makes a series of recommendations designed to facilitate good practice in caregiver participation in social work education

Learning lessons about self-neglect? An analysis of serious case reviews

Purpose – The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect. Design/methodology/approach – The study comprised analysis of 40 SCRs where self-neglect featured. The reviews were found through detailed searching of Local Safeguarding Adult Board (LSAB) web sites and through contacts with Board managers and independent chairs. A four layer analysis is presented of the characteristics of each case and SCR, of the recommendations and of the emerging themes. Learning for service improvement is presented thematically, focusing on the adult and their immediate context, the team around the adult, the organisations around the team and the Local Safeguarding Board around the organisations. Findings – There is no one typical presentation of self-neglect; cases vary in terms of age, household composition, lack of self-care, lack of care of one's environment and/or refusal to engage. Recommendations foreground LSABs, adult social care and unspecified agencies, and focus on staff support, procedures and the components of best practice and effective SCRs. Reports emphasise the importance of a person-centred approach, within the context of ongoing assessment of mental capacity and risk, with agencies sharing information and working closely together, supported by management and supervision, and practising within detailed procedural guidance. Research limitations/implications – There is no national database of SCRs commissioned by LSABs and currently there is no requirement to publish the outcomes of such inquiries. It may be that there are further SCRs, or other forms of inquiry, that have been commissioned by Boards but not publicised. This limits the learning that has been available for service improvement. Practical implications – The paper identifies practice, management and organisational issues that should be considered when working with adults who self-neglect. These cases are often complex and stressful for those involved. The thematic analysis adds to the evidence-base of how best to approach engagement with adults who self-neglect and to engage the multi-agency network in assessing and managing risk and mental capacity. Originality/value – The paper offers the first formal evaluation of SCRs that focus on adults who self-neglect. The analysis of the findings and the recommendations from the investigations into the 40 cases adds to the evidence-base for effective practice with adults who self-neglect

Broadening the vision: law teaching, social work and civil society

In the context of debates about social work’s relationship with individuals, the state and civil society, educators face a challenge. How best to ensure that professional education prepares practitioners to engage with the task of promoting social justice and human rights? This article draws on a systematic knowledge review of learning, teaching and assessment of one key subject area in social work education - that of law - to explore the contribution legal knowledge and skills can make to social work’s engagement with its vision of empowerment and liberation

A scoping review of workforce development for self-neglect work

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Autonomy and protection in self-neglect work: the ethical complexity of decision-making

Self-neglect, in which an individual does not attend to their hygiene, health or home surroundings, is one of the most challenging aspects of adult social care practice. In England, its inclusion within the remit of adult safeguarding, as a result of changes in adult social care law introduced under the Care Act 2014, has thrown into relief the ethical dilemmas arising from tensions between respect for autonomy on the one hand and the exercise of a protective duty of care on the other. This paper draws on serious case reviews and safeguarding adult reviews in self-neglect cases, along with findings from adult safeguarding research, to propose that an appropriate balance between these two moral imperatives is not always achieved in self-neglect practice. It considers why autonomy appears to be privileged over other considerations, illustrating the complex interplay between law and ethics that gives autonomy pre-eminence. It then considers how a more nuanced, situated and relational approach to autonomy can enable practitioners to move away from dichotomous interpretations of the moral imperatives present in self-neglect work, and can support more nuanced understandings of the ethics of professional decision-making. Finally it considers the personal and organisational implications of this enhanced ethical literacy

Meaning in hoarding: perspectives of people who hoard on clutter, culture, and agency

Hoarding has become increasingly prominent in clinical practice and popular culture in recent years, giving rise to extensive research and commentary. Critical responses in the social sciences have criticised the cultural assumptions built in to the construct of ‘hoarding disorder’ and expressed fears that it may generate stigma outweighing its benefits; however, few of these studies have engaged directly with ‘hoarders’ themselves. This paper reports on in-depth, semi-structured interviews with ten individuals living in England, who received assessment and intervention for hoarding from Social Services. Their narratives drew on the cultural repertoire of values and discourses around waste and worth, the mediation of sociality and relationships through material objects, physical constraints on keeping order, and the role played by mental health. Analysing these perspectives anthropologically shows how dominant models of hoarding, such as the DSM-5 paradigm, potentially lend themselves to reductionist understandings that efface the meaning ‘hoarding’ may have and thereby deny agency to the person labelled as ‘hoarder’. More culturally informed analysis, by contrast, affords insights into the complex landscape of value, waste, social critique, emotion, interpersonal relationships and practical difficulties that may underlie hoarding cases, and points the way to more person-centred practice and analysis

The role of law in welfare reform: critical perspectives on the relationship between law and social work practice

This paper considers the complex relationships between law, welfare policy and social work practice, to address the question of what role legal frameworks might play in achieving welfare policy and professional practice goals. The authors trace how law has developed as a core component of professional practice, and challenge some of the false expectations placed upon it. They then draw on findings from an international knowledge review of law teaching in social work education to propose a model for understanding how professional practice incorporates legal perspectives, and propose ways in which legal frameworks can provide positive and constructive vehicles for accountable practice

Calcium carbonate-calcium phosphate mixed cement compositions for bone reconstruction

The feasibility of making calcium carbonate-calcium phosphate (CaCO3-CaP) mixed cements, comprising at least 40 % (w/w) CaCO3 in the dry powder ingredients, has been demonstrated. Several original cement compositions were obtained by mixing metastable crystalline calcium carbonate phases with metastable amorphous or crystalline calcium phosphate powders in aqueous medium. The cements set within at most 1 hour at 37°C in atmosphere saturated with water. The hardened cement is microporous and exhibits weak compressive strength. The setting reaction appeared to be essentially related to the formation of a highly carbonated nanocrystalline apatite phase by reaction of the mestastable CaP phase with part or almost all of the metastable CaCO3 phase. The recrystallization of metastable CaP varieties led to a final cement consisting of a highly carbonated poorly crystalline apatite (PCA) analogous to bone mineral associated with various amounts of vaterite and/or aragonite. The presence of controlled amounts of CaCO3 with a higher solubility than the apatite formed in the well-developed calcium phosphate cements might be of interest to increase resorption rates in biomedical cement and favor its replacement by bone tissue. Cytotoxicity testing revealed excellent cytocompatibility of CaCO3-CaP mixed cement compositions